Senate Bill: Ensign Healthcare Loophole sets high pre-existing condition penalties.

[freddie mertz]

Published on Friday, January 8, 2010 by The Nation

The Ensign Healthcare Loophole

by Greg Kaufmann

Taken at face value, Senator John Ensign's amendment which was included in the final Senate healthcare bill sounds pretty decent: by meeting "wellness" standards people can receive discounts on their employer-based healthcare premiums. Stop smoking--pay less. Hit a certain weight--pay less. Meet a cholesterol target--you get the idea.

Dems probably should have stopped and realized since the amendment was offered by Ensign it probably wasn't motivated by "wellness" at heart.

In fact, it allows premiums to be raised from current levels, and then "discounts" would reduce the premiums to current rates. People who don't meet the insurance companies' targets could pay up to 30 percent more for coverage, roughly $4000 based on the average cost of family coverage. The amount could increase to 50 percent which is over $6,600 for a family.

There is also the problem that this is biased against people with a genetic predisposition to high blood sugar, hypertension, high cholesterol, being overweight and a host of other often hereditary conditions. It's also biased against a lower-income person working two to three jobs to pay the bills, who has to stop and chow down some fast food between jobs rather than get to the gym where he or she can't afford a membership anyway. It's even biased against communities that don't have grocery stores where they can find fresh fruits and vegetables.

So what does this all mean? Remember a central promise of healthcare reform--even the watered down version--how people with preexisting conditions weren't supposed to be denied coverage or forced to pay more for their insurance? That all sounded pretty good, right? Well, guess again.

"Incentives quickly become penalties for those who cannot meet the target," said Sue Nelson, vice president for federal advocacy at the American Heart Association (AHA). The AHA has led a coalition of more than 200 health and consumer organizations who oppose this Senate provision, including the National Organization for Women, American Cancer Society, the American Diabetes Association, and many mental health groups. "A wellness program could consist solely of a premium surcharge based on a blood cholesterol count over 200. are significant potential unintended consequences such as burdening sicker employees and their families with significant increases in healthcare costs thereby making coverage unaffordable for those who need it the most."

Andrew Kurz, former chief financial officer of Wisconsin Blue Cross-Blue Shield, probably knows as well as anyone what the loophole means for Big Insurance.

"Wall Street demands focus on the bottom line, and insurers comply," he said. "Insurers can spot profits miles away and this is a loophole they will drive right through on Day One. As drafted, this provision will not only harm millions of Americans who will be forced to pay higher premiums. It will harm other efforts to bar insurance companies from discriminating against customers."

Ultimately it's Democrats, not Senator Ensign, who bear the responsibility for the inclusion of this insane provision. (And apparently Chairman Max Baucus spoke against this amendment in Committee before he voted for it in "the spirit of bipartisanship"--thanks again, Max.) Now is the moment to contact your legislators and tell them to rid the final healthcare bill of this gift to insurance--found in Section 2705 of the Senate bill.

© 2010 The Nation

http://www.commondreams.org/view/2010/01/08-12

[freddie mertz]

1. More change you can't believe in, and which could end up killing you.

Thanks to Sen. Ensign and his Democratic collaborators.

[Vinca]

2. There's no reason at all to include any Republican amendments

since they are all going to vote against it anyway. Strip 'em out.

[freddie mertz]

3. I think there are very many Repub amendments in both bills.

Problem is, very few in the Washington Dem establishment are listening, if they ever did, to their constituents anymore.

[shopgreen]

5. ha ha. Like that is going to happen!!

[dkf]

4. I'm sure there are a lot more of these in the bill.

Insurance companies are a lot more crafty at inserting favorable language than congress is at deciphering it.

[highplainsdem]

10. I'm worried about that, too.

[liberal_at_heart]

12. We're told we should call our congressmen

These negotiations are behind closed doors. They keep coming up dozens and dozens of these amendments. It's hard to keep up which is exactly what they want. They want us to be confused.

[dana_b]

6. damn him

but I'm not surprised by him, Baucus or any of this anymore.

[freddie mertz]

7. Kicking because it is not well known.

[laughingliberal]

8. Yeah, it's not known

I've been hammering on it regularly in other posts but it did need its own post. In addition to the fact that a Democratic president should have immediately reversed Bush's last minute executive order that allows your employer access to your private health information this loophole pretty much abolishes that whole lie that you can't be charged more for preexisting conditions.

[liberal_at_heart]

9. I will never support this bill and will not vote for any politician who does

There is going to be a loophole in favor of the insurance company at every turn.

[mdmc]

11. I can't wait to be bedazzled into hearing why this is a good idea

lets hear why this is a good idea. Or was it ditched?

[brentspeak]

14. I expect Ezra Klein to write a column explaining why liberals should support this

And why we shouldn't let it "prevent us from passing this once-in-a-lifetime opportunity."

[mdmc]

15. This failure of a bill will be a victory for Obama

and when it fails to increase access to affordable health care, Obama will recognize that true reform is needed.

[Dr.Phool]

13. And, if you go to Ensigns veterinary clinic for treatment

He'll wave half of your co-pay.

He'll cancel your deductible if he can screw your wife.